May 1st 2025
Approximately 1 million Aetna members will need new coverage with the announcement that CVS will be leaving the Affordable Care Act (ACA) individual exchange business next year.
Health Equity and Access Weekly Roundup: January 13, 2024
January 13th 2024The Center on Health Equity and Access provides up-to-date news, showcases research advancements, and ongoing initiatives dedicated to tackling healthcare disparities and enhancing overall accessibility to outstanding care.
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Fabric Health: Navigating Complex Health Care Systems Through Community Engagement
January 10th 2024A social-impact startup, Pittsburgh-based Fabric Health is adept at using community engagement to help members and their families navigate the complex world of health care—meeting customers where they are at, knowing time is often their most valuable resource.
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Breaking Barriers in Bleeding Disorders: Experts Call for More Data on Women
January 8th 2024“These autosomal diseases, from an inheritance standpoint, affect men and women equally, but because of their impact on the gynecological system and menses, women are often affected much more than men," hematologist Donna DiMichele, MD, explains.
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Dr Margaret Liang on Mitigating Financial Toxicity for Patients With Cancer
January 6th 2024Margaret Liang, MD, MSHPM, gynecologic oncologist and health services researcher and director, Gynecologic Oncology Fellowship Program, Cedars-Sinai Cancer Center, discusses financial toxicity in cancer care and how institutions can help alleviate the financial burden for patients.
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Health Equity and Access Weekly Roundup: January 6, 2023
January 6th 2024The Center on Health Equity and Access delivers current news, highlights research advancements, and continuous initiatives focused on addressing health care disparities and improving overall accessibility to exceptional care.
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What We’re Reading: Rising Hospital Care Costs; New Antibiotic; Disenrolled Medicaid Beneficiaries
January 4th 2024The average direct cost for hospital treatment for patients with COVID-19 in the United States rose by 26% from 2020 to 2022; scientists have developed a new type of antibiotic to treat a deadly bacteria resistant to most current antibiotics; a survey conducted for Utah state officials gave some clues as to why millions of Americans lost Medicaid coverage last year.
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What We’re Reading: Drug Price Increases; FDA Approvals Rise; Abortion Pill Demand Surge
January 3rd 2024Drugmakers are expected to increase prices on more than 500 drugs early this month; the FDA approved nearly 50% more novel drugs in 2023 than in 2022; the number of Americans who were not pregnant and wanted abortion pills increased by nearly 10 times after the Supreme Court’s 2022 Roe v Wade decision leaked.
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What We’re Reading: Mental Hospitals for Addiction; Insulin Price Cap; e-Cigarette Crackdown
January 2nd 2024Lawmakers contemplate the return of mental health institutions in response to the drug crisis; new measures to rein in insulin prices take effect; FDA intensifies efforts to curb the teen vaping epidemic.
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CareFirst Files Lawsuit Against J&J Over Delay Tactics for Stelara Biosimilars
January 1st 2024While the first ustekinumab biosimilar, Wezlana, was approved in October 2023, a settlement with Johnson & Johnson (J&J) will keep it off the market until 2025, preventing competition, and causing purchasers to pay substantially more for the agent.
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Top 5 Most Popular Reimbursement Content of 2023
December 31st 2023The most popular reimbursement content of 2023 included coverage of the shift from the Oncology Care Model to the Enhancing Oncology Model, reactions to the 2024 Medicare Physician Fee Schedule, and concerns around denial of services in Medicare Advantage plans.
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More-Expensive SMA Medication Use Led to Lower Health Care Resource Utilization
December 27th 2023Patients with spinal muscular atrophy (SMA) treated with a more expensive medication were found to have higher pharmacy costs but lower SMA-related health care resource utilization and medical costs compared with patients receiving standard-of-care nusinersen monotherapy.
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Top 5 Most-Read Articles From the Center of Health Equity and Access 2023
December 25th 2023The top articles of 2023 addressed key issues such as representation gaps in aRCC research, concerns about the 340B program's impact on asthma disparities, slow adoption of equity innovations, potential biases in type 2 diabetes risk models, and addressing disparities in psoriasis treatment based on race and culture.
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Health Plan Design: Employers as the Architects of Health Equity
December 22nd 2023Employers, recognized as pivotal contributors to health equity, are urged to prioritize equitable benefits, address the complexity of health plans, and engage in education, data-driven interventions, and systematic measurements to comprehensively improve outcomes for diverse employee populations.
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Community and Connection Drive UPMC Health Plan’s Multifaceted Success
December 22nd 2023In September, The American Journal of Managed Care® joined 4 individuals whose involvement with UPMC Health Plan, a Strategic Alliance Partner of AJMC®, has proved to be instrumental in furthering health equity and providing high-quality care in Pennsylvania, Ohio, West Virginia, and Maryland.
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ICYMI: AMCP Nexus Conference Highlights
December 19th 2023From the 2023 Academy of Managed Care Pharmacy (AMCP) Nexus meeting, held in October, expert interviews and insightful updates on the Inflation Reduction Act, gene therapy affordability and access, and the 340B Drug Pricing Program comprise the conference highlights.
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Australian Government Pricing Policy Saved Over $6 Million After Etanercept Biosimilar Launched
December 16th 2023The government of Australia’s pricing policy links the price of new medications with similar safety and efficacy, resulting in significant savings over the first 3 years after the etanercept biosimilar Brenzys was introduced.
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